Soldiers from The Royal Mechanical and Electrical Engineers (REME), The Royal Logistic Corps (RLC) and the Royal Tank Regiment (RTR) remove a contaminated vehicle from the Accident and Emergency entrance at Salisbury Hospital in Wiltshire on Operation MORLOP, in response to a request from the police.

Chemical attacks: a tale of two cities

To review and assess CBRN defence and security in densely populated areas, two wildly contrasting, unfolding events of world importance emerge as apt case studies. Both involved chemical weapons (CW). In chronological, not lethality order: the poisoning of a former Russian double agent, Sergei Skripal, his daughter Yulia, and a police officer, Det Sgt Det Sgt Nick Bailey, in Salisbury on 4 March, and the mass-casualty chemical attack on a rebel-held area in Douma, east Ghouta, Syria on 7 April.

The response in each was as different as one would expect: the first, limited and targeted attempted murder took place in a small town in peacetime England, the second, a mass-casualty attack in a country torn and ravaged by a six-year-long civil war in which a half a million people have died and where CW attacks have become a regular occurrence.

The first involved, to all intents and purposes, a nation state wielding a CBRN material against specific individual targets: a rare nerve agent in the Novichok series, developed in the 1970s in the Soviet Union to evade detection and NBC suit protection. The second involved the latest in a series over five years of aerial barrel bombardments of chlorine, most likely delivered by Syrian forces, which killed at least 70 and injured some 500 civilians, many of them children. While both events are in totally different circumstances, they may serve to illuminate the problems of response – even in developed countries at peace – to a CBRN event in a populated area.

Response: Salisbury

The targeted assassinations in Salisbury required complicated investigation, response and remediation. For the first time in Britain, military specialist CBRN personnel were deployed in support of a chemical weapon attack investigation: Falcon Squadron from the Royal Tank Regiment, deploying the renowned Fuchs mobile laboratories to carry out tests, decontamination and sensitive-site exploitation. Over 200 counter terrorism officers continue to work on one of the most complicated cases ever investigated in the UK. They have 5,000 hours of CCTV footage and 1,350 seized items to examine.

Although only a small amount of the nerve agent was administered, confirmed as in liquid form, decontamination of nine sites were set to begin in mid-April, with the Skripal house where most of the agent was found remains cordoned off. After a pause for the Easter holiday Salisbury residents were warned to expect increased activity and the return of NBC-suited investigators as they remove items and decontaminate the sites. Anyone who had been on or near the named sites was advised to launder their clothing or bag it up for council collection. Businesses have taken a 20% fall.

The Department for the Environment will hire specialist contractors and the assistance of 200 military personnel to clean the areas: the Zizzi restaurant where the Skripalsate, The Mill pub, ambulance stations, a police car compound, and an access route through The Maltings shopping area near where they collapsed. While public risk is low, caustics will be used as nerve agent does not dissipate and clear-up involves repeated application and removal of the run-off liquids. Much contaminated material will be incinerated.

Dealing with health effects

While only four people were affected by the Salisbury attack,the long-term health effects are still unknown – especially as the agent applied for a targeted attempted assassination is so rare, with little known use. The recovery of the Skripals and Det Sgt Bailey was due mainly to theexcellent hospital treatment after they were found: maintaining heartbeat and respiration, intensive supportive care and antidotes. Atropine is now kept on board all UK NHS ambulances and helps to eliminate nerve agent chemicals in the system.

The unfortunate civilians in Syria have rarely had the benefit of intensive, top-line medical intervention and readiness despite the heroic efforts of beleaguered rescue and medical workers, various charities and support agencies.

In all the 85 reported CW attacks on Syrian civilians, four of which were confirmed by the OPCW and involved sarin nerve agent, nothing like full decon of an area or after-care for victims would be available.

OPCW inspectors finally allowed into Douma 11 days since the 7 April attack are expected to gather soil and other samples – if there are any not already removed by the Syrians and Russians – to identify the CWA, according to intelligence and witness accounts believed to have been chlorine and possibly sarin as well, and take eyewitness and victim accounts; blood and urine samples; also examining remnants of canisters or other CW delivery systems, and soil samples and buildings fragments. This all has to be done with many obstacles in their path and ongoing warfare.

What of the victims?

As for the injured victims, The World Health Organization said that according to reports from its medical partners in Douma, an estimated 500 patients presented to health facilities exhibiting signs and symptoms consistent with exposure to toxic chemicals. More than 70 people sheltering in basements reportedly died, with 43 having suffered suffocation, central cyanosis, foaming, corneal burns and the emission of chlorine odour.

While their horrific suffering is shown on worldwide news networks, finding out what was used and who used it overshadows what happens next to the victims. With many hospitals deliberately targeted and whole cities bombed to bits, treatment and equipment is sparse and sometimes limited to a wash down with water, which is often contaminated. Many do not survive and could only be extracted from ruined homes once the gas dissipated. Rescue workers are also exposed to the alleged chemicals.

The featured image is of British Army troops were deployed in the Salisbury investigation – the first time troops were seen on British streets in response to a CW attack. The featured image is owned by Crown copyright.